Crew reduces harm, challenges perceptions and helps people make more informed choices about alcohol, cannabis, club drugs and new drugs (New Psychoactive Substances [NPS] or 'Legal Highs') by providing non-judgemental, credible, up to date information and support. Crew delivers services using a 'stepped care model':

Step one. Prevention and education through training for professionals, Drop-in shop, My Crew online information resource, outreach services including work at festivals and nightlife settings across Scotland and Curriculum resources for children and young people in schools and youth work agencies Scotland wide.

Step two. Brief interventions and crisis support when and where people need this: Drop-in shop, telephone support, My Crew's online chatroom, tracking tool and new mobile phone app; outreach services including nightlife in Glasgow and Edinburgh, and national music festivals and person-centred, outcome-focussed counselling for people aged 16 and over.

Step three. Intensive support for recovery, for people whose drug use has become problematic, through person-centred, outcome-focused counselling, CBT, Mindfulness and alternative therapies.

Step four. Developing social networks for people in recovery to help them sustain positive health and behaviours which involves establishing support groups, for example SMART (Self- managed Recovery Training) meetings and individual support packages.

Intervention details

Type of intervention

Outreach, Crisis intervention

Intervention setting

Bar

Community

Primary health care settings

Event

Youth clubs

Club/disco/afters

Internet

Social media

App (smartphone or tablet application)

School

Secondary school

Higher education or university

Target population

Anyone affected by psychostimulant drug use. We do not wait for young people to become problematic users and offer harm reduction advice to anyone considering trying substance use.

Actions

Peer development of the My Crew website to deliver current, credible information on drug harms and harm reduction Peer development and dissemination of harm reduction lanyards and other culturally credible materials tailored to specific markets Peer-delivered advice and information at festivals Training and workshops across Scotland Curriculum development to increase knowledge and understanding or risk minimisation strategies and encourage critical thinking Input into Policy/guidance: Trading Standards Scotland guidance on NPS; NEPTUNE Clinical Guidance on NPS treatment; Scottish Government Expert Group on NPS; Pan Lothian NPS Strategy; EMCDDA NPS Treatment event October 2015 Training for GPs, Nurses, Licensing Boards, Prison staff and Prisoners, medical students and youth workers Person-centred, goal oriented counselling for people wishing to reduce, stabilise or stop drug use Recovery support to encourage our clients to link in with recovery networks and increase their recovery capital Internal evaluation using 360 degree feedback External evaluation as part of the GSK IMPACT Awards process assessing and recognising excellence in community health care Cascading Leadership pilot project as part of the GSL IMPACT Awards Alumni Network

Theory/evidence behind the intervention

In the intervention the core values of acceptance, congruence and empathy in all interactions are promoted. This approach, enacted through the methodology of motivational interviewing, is more likely to engage people and support them to adopt positive behaviour change. Motivational interviewing is proven to be an effective intervention for outreach/transient settings where people may exhibit ambivalence to harm reduction messages and interventions.

Evaluation details

Each intervention is outcome-evaluated. As part of preparation a process evaluation was conducted for a competitive tendering process to sustain our counselling service.

Type of evaluator (e.g. external consultant, internal evaluator)

Internal evaluator

Evaluation results (Outcome evaluation)

A 30% decrease in reported poly drug use can be demonstrated among young people accessing Crew and completing questionnaires at festivals 2014-15 from our outcome evaluation.

Drop In evaluation forms and surveys indicated that 4,925 service users accessed the Drop In during 2015 of which 71% were aged 12-25 years and 68% were return users. 91% of young people felt the quality of drug information was good/very good and 82% thought the staff were welcoming and provided a good service. This data suggests a need for the service among young people in Edinburgh and an indication that once they engage with the Drop In, many like the service enough to return. Qualitative feedback from young service users supports this and includes; very welcoming, relaxed and pure awesome!; very helpful and understanding; I feel like I understand more; Defo wouldn't touch legal highs now, might have before; good to know there's support

Feedback from LGBT Youth's mystery shopper visit included commendations for our informative website and use of social media, good understanding of the different needs of young people, accessible opening times reflective of young people's needs, warm and welcoming environment with the volunteer/staff member ensuring the young person gained as much from their visit as they possibly could.

A survey conducted with 76 Edinburgh College students in 2015 highlighted the good work that the service is doing (57% have accessed the Drop In for information, advice and support on drugs and sexual health and found it to be beneficial). Students reported where they felt gaps existed in the current service, identifying that they would like to see blood borne virus (BBV) testing (78%) and pregnancy testing (72%) offered in the Drop In, whilst 41% said they would benefit from Drop In resources being made available on campus. These results are comparable to the findings from the Crew User Impact Survey (2015) where 208 young service users took part and as such the suggestions have now been incorporated into the planned expansion of the service.

Findings from the Scottish Youth Parliament report (2015) 'Tackling New Psychoactive Substances; a report on the views of young people' support the development of our existing service and include the following recommendations: a. Increased knowledge and awareness of New Psychoactive Substances (NPS) b. Information should be accessible, young person-friendly and localised c. Young people should be involved in the design and delivery of information on NPS d. The tone of information about NPS should be balanced, pragmatic and not patronising e. The provision of advice services should be increased f. There should be further training and support for education/youth professionals about NPS g. Where possible a peer-led and youth-led approach should be used for the dissemination of information and advice

The Drop In has received an increasing amount of anecdotal evidence suggesting a need to work with frontline workers and vulnerable young people. This has been in the form of increasing numbers of enquiries and visits from frontline staff in Edinburgh who are worried about a young person's drug or alcohol use. In addition, we have also received enquiries from teachers at a number of Edinburgh high schools who have identified pockets of drug use among pupils and who have also had parents contact them, worried about their child's drug use. Further enquiries from concerned adults have come from the Wester Hailes area where NPS use among young people in the area has grown significantly and workers don't know how to respond. This evidence indicates that frontline workers recognise the Crew Drop In as a source of reliable and credible information, advice and support and further suggests the benefit of expanding the current service to meet the needs of frontline workers and vulnerable young people.